in practice: guidance on maintaining clear sexual boundaries...in practice: guidance on maintaining...
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In practice: Guidance on maintaining clear sexual boundaries
Revised
May 2017
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© General Pharmaceutical Council 2017
Contents
About this guidance ............................................................................................................ 4
Guidance on maintaining clear sexual boundaries ........................................................ 6
1. The importance of maintaining clear sexual boundaries .................................................. 6
2. Power imbalance ....................................................................................................................... 6
3. Sexualised behaviour and breaches of sexual boundaries ................................................ 7
4. Avoiding breaches of sexual boundaries .............................................................................. 8
5. Cultural and other differences................................................................................................ 9
6. Chaperones ................................................................................................................................ 9
7. People who have previously received care ........................................................................... 10
8. Raising concerns ........................................................................................................................ 10
Other sources of information ............................................................................................ 11
In practice: Guidance on maintaining clear sexual boundaries
4
About this guidance This guidance explains to pharmacy
professionals (pharmacists and
pharmacy technicians) the importance
of maintaining clear sexual
boundaries, and their relevant
responsibilities. Pharmacy
professionals should use their
professional judgement in applying
this guidance.
Pharmacy professionals must satisfy themselves
that all members of their team are aware of this
guidance and are appropriately trained in all
areas relevant to their duties.
If a pharmacy professional is not sure about
what they should do in a specific situation, they
should always ask for advice from their
employer, professional indemnity insurance
provider, union, professional body or other
pharmacy organisation, or get independent legal
advice.
This guidance should be read alongside the
standards for pharmacy professionals which
all pharmacy professionals must meet. This
guidance covers standard 6 of the standards for
pharmacy professionals, which says:
The General Pharmaceutical Council is the regulator for pharmacists, pharmacy technicians and registered pharmacies in England, Scotland and Wales. As part of our role, we set the standards that pharmacy professionals have to meet throughout their careers.
In practice: Guidance on maintaining clear sexual boundaries
5
Pharmacy professionals must behave in a
professional manner
Applying the standard
People expect pharmacy professionals to behave
professionally. This is essential to maintaining
trust and confidence in pharmacy. Behaving
professionally is not limited to the working day,
or face-to face interactions. The privilege of being
a pharmacist or pharmacy technician, and the
importance of maintaining confidence in the
professions, call for appropriate behaviour at all
times. There are a number of ways to meet this
standard and below are examples of the
attitudes and behaviours expected.
People receive safe and effective care when
pharmacy professionals:
• are polite and considerate
• are trustworthy and act with honesty and
integrity
• show empathy and compassion
• treat people with respect and safeguard
their dignity
• maintain appropriate personal and
professional boundaries with the people
they provide care to and with others
We have a range of guidance on our website to
help pharmacy professionals apply our
standards.
In practice: Guidance on maintaining clear sexual boundaries
6
Guidance on maintaining clear sexual boundaries 1. The importance of
maintaining clear
sexual boundaries
1.1. When healthcare professionals cross
personal and professional boundaries the
result for people under their care can be
serious and can cause harm. Crossing
these boundaries can damage public trust
and confidence in the pharmacy profession
and other healthcare professions.
1.2. People receiving care must be able to trust
that pharmacy professionals will act in their
best interests. If pharmacy professionals
are sexually, or inappropriately involved
with a person under their care their
professional judgement can be affected.
This involvement may affect the decisions
that they make about a person’s
healthcare.
2. Power imbalance
2.1 People receiving care are in a vulnerable
position. In the relationship between a
healthcare professional and a person
under their care, there is often a power
imbalance. This may be because personal
information is shared with the pharmacy
professional or because they have
information and resources (such as
medicines) that are needed. The person
receiving care may not know what is
appropriate professional behaviour. They
may not be able to judge whether the
relationship, or what happens to them, is
appropriate. It is the pharmacy
professional’s responsibility to be aware of
the imbalance of power and to maintain
clear personal and professional boundaries
at all times.
2.2 Pharmacy professionals should always be
clear with the person receiving care about
the reason for an examination or why they
want them to come into the consultation
room. The person receiving care should be
given all the information they need and the
opportunity to ask questions, and they
should give their consent before the
pharmacy professional goes with them into
a consultation room.
In practice: Guidance on maintaining clear sexual boundaries
7
3. Sexualised behaviour
and breaches of sexual
boundaries
3.1 The Professional Standards Authority (PSA)
provides its own guidance on the
responsibilities that healthcare
professionals have on maintaining clear
sexual boundaries between healthcare
professionals and patients. The PSA
document defines sexualised behaviour as
‘acts, words or behaviour designed to
arouse or gratify sexual impulses or
desires’.
3.2 A breach of sexual boundaries is not
limited to criminal acts, such as rape or
sexual assault. For example, carrying out
an unnecessary physical examination or
asking for details of sexual orientation
when it is not necessary or relevant, would
both be a breach.
In practice: Guidance on maintaining clear sexual boundaries
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4. Avoiding breaches of
sexual boundaries
4.1 There are a number of behaviours that
may be signs of showing sexualised
behaviour towards people receiving care or
carers. These include:
When the healthcare professional
reveals intimate personal details about
themselves to a person under their care
during a consultation
When the reason behind the following
actions is sexual:
giving or accepting social invitations
(dates and meetings)
visiting a home of a person under
their care without an appointment
meeting people under their care
outside of normal practice, for
example arranging appointments
for a time when no other staff are in
the pharmacy, or
asking questions unrelated to a
person’s health.
4.2 If a pharmacy professional finds
themselves in a situation where they are
attracted to a person under their care, they
must not act on these feelings. If they have
concerns that this may affect their
professional judgement, or if they are not
sure whether they are abusing their
professional position, they may find it
helpful to discuss this with someone else.
They might discuss this with an impartial
colleague, a pharmacy organisation that
represents them, a professional leadership
body or their professional indemnity
insurance provider.
4.3 If pharmacy professionals cannot continue
to care for the person and be objective,
they should find other care for the person.
They must make sure there is a proper
handover to another pharmacy
professional and that the person receiving
care does not feel that they are in the
wrong as a result of these actions.
4.4 There may be situations when people
receiving care or their carers are attracted
to a pharmacy professional. If a person
receiving care shows sexualised behaviour
towards a pharmacy professional, the
pharmacy professional should think about
whether they should discuss the person’s
feelings in a constructive way and try to re-
establish a professional relationship. If this
is not possible, they should transfer the
person’s care to another pharmacy
professional. A pharmacy professional may
find it helpful to discuss the matter with a
colleague, a pharmacy organisation that
represents them, a professional leadership
body or their professional indemnity
insurance provider.
In practice: Guidance on maintaining clear sexual boundaries
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5. Cultural and other
differences
5.1 Cultural differences can affect a person’s
view of their personal boundaries and what
is appropriate. Pharmacy professionals
need to be sensitive to this, and always
treat people receiving care as individuals in
a way that respects their views and
maintains their dignity. For example, an
individual may prefer to talk to or be
examined by a pharmacy professional of
the same gender, or have another person
present. (See 6 Chaperones)
6. Chaperones
6.1 A chaperone is a person (usually the same
sex as the patient) who is present as a
safeguard for the person receiving care and
the healthcare professional. They are also a
witness to the person’s continuing consent
for the procedure. Their role may vary
depending on the needs of the person, the
pharmacy professional and the
examination or procedure being carried
out.
6.2 The pharmacy professional should ask the
person receiving care whether they would
like a chaperone to be with them in the
consultation room, and for any
examination that they might consider to be
intimate. The pharmacy professional
should discuss the need for a chaperone
with the person receiving care and should
not guess what their wishes are.
6.3 Pharmacy professionals should record any
discussion that they have with a person
receiving care about chaperones, including
when they do not want to have a
chaperone present.
6.4 If no chaperone is available, the pharmacy
professional should offer to delay and re-
arrange the consultation or examination
until one is available (unless a delay is not
making the care of the person their first
priority).
In practice: Guidance on maintaining clear sexual boundaries
10
7. People who have
previously received care
7.1 The same principles apply to carers or
people who have received care from
pharmacy professionals in the past. The
previous professional relationship may also
have involved an imbalance of power, and
so would affect any personal relationship. If
this type of relationship develops, the
consequences should be considered and
any harm this may cause to the person.
The impact on the professional standing of
the pharmacy professional should also be
considered. We advise pharmacy
professionals to consider the following:
how long the professional relationship
lasted and when it ended
the nature of the previous professional
relationship and whether it involved a
significant imbalance of power
whether the former person under their
care or carer was, or is, vulnerable
whether the knowledge or influence that
was gained through the professional
relationship is being used to develop or
continue the personal relationship, and
whether they are already treating, or are
likely to treat, any other members of the
former person under their care or
carer’s family.
7.2 It is the pharmacy professional’s
responsibility to act appropriately and
professionally, even if the relationship is
agreed by everyone involved. They must
consider all the issues above and, if
necessary, get appropriate advice.
8. Raising concerns
8.1 Pharmacy professionals have a
professional duty to raise concerns if they
believe the actions of other individuals are
putting patients at risk. This would include
when they are concerned that clear sexual
boundaries have not been maintained by
colleagues or other healthcare
professionals. They must also take
appropriate action if others report
concerns to them.
8.2 See our In practice: Guidance on raising
concerns for more information.
In practice: Guidance on maintaining clear sexual boundaries
11
Other sources of information Clear sexual boundaries between healthcare
professionals and patients: responsibilities
of healthcare professionals, PSA:
www.professionalstandards.org.uk
Chaperone Framework, PSNC:
www.psnc.org.uk
If you have questions or comments about the content of this guidance, please contact our Policy and Standards Team: Policy and Standards Team General Pharmaceutical Council 25 Canada Square London E14 5LQ
0203 713 8000
We have also produced guidance on other topics that you may find useful:
www.pharmacyregulation.org/ standards/guidance